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  • Should Ethicists Hide Consult Notes from Patients?

    Ethics consults often are accompanied by conflict, intense emotions, sensitive or controversial topics, and disagreements about values. Ethics notes tend to incorporate more narrative and explicit analysis than other clinical notes. For the sake of transparency, instead of shielding notes, consider excluding details that are likely to cause harm.

  • Efforts Underway to Diversify Clinical Ethics Field

    Success depends on available ethics resources and overall organizational diversity. Broader changes to the ethics field resulting in more diversity would require regulatory, legal, or accreditation oversight. Absent that, it is going to be one institution at a time, or one or several ethicists at a time, trying to create the right kind of mix of diversity and representation.

  • Physicians’ Well-Being Top Ethics Issue

    Ethicists should encourage their organizations to survey physicians to identify which factors are adversely affecting well-being. Meaningful change cannot occur without actively engaging physicians in determining what changes they believe will significantly improve their health and well-being.

  • Ethicists Can Intervene if Patient/Physician Relationship Is Beyond Repair

    It is important to remember that if serious conflict with a patient arises, clinicians should not act in a knee-jerk way. A primary care practitioner might use ethics practice guidelines to create a consistent approach for dealing with these cases.

  • How to Respond to a Consult Request for ‘Difficult’ Family

    Clinicians sometimes overlook the fact there are many contributing factors when a patient or family member displays “difficult” behavior. Ethicists can help clinicians parse those, recognize their own internal biases, and think about the family’s perspective.

  • Out of Options: When Parents Abandon Pediatric Psychiatric Patients at Hospital

    Parents often are faced with an impossible choice. They must decide whether to bring home a child who poses a threat to self and others, or risk a child abandonment charge. The criteria for acute psychiatric hospitalization are so high that children might be discharged only to be rehospitalized within weeks or days — and retraumatized in the process.

  • More Transparency Might Bolster Trust in FDA Advisory Committees

    The FDA does not always convene an advisory committee meeting in connection with application reviews, but may do so when questions related to safety or the data submitted to support approval arise. In the modern environment, some believe if they cannot see it, foul play must be afoot. Some of that could be allayed by transparency and more public education.

  • Trauma Patients at Risk for Developing Opioid Use Disorder

    Better identification and referral of patients with opioid use disorder could enhance the quality and continuity of care these patients receive, while also reducing reliance on EDs and the crowding that ensues.

  • Ethical Responses if Family Abandons Loved One at Hospital

    By leveraging their mediation skills, ethicists can build trust between weary family caregivers and clinicians who are unsure about how to handle a delicate situation. This can help everyone identify patient needs and find possible solutions.

  • Shortage of Nursing Home Beds Prompts Creative Solutions

    The nursing home crises of too few beds and not enough staff is expected to continue for the foreseeable future. Case managers, discharge planners, and transition of care leaders need to find alternative solutions that will keep patients safe and avoid unnecessary hospitalizations.